Education level affects dual-task gait after deep brain stimulation in Parkinson's disease

Wegrzyk, Jennifer (Department of Neurology, Geneva University Hospitals, Geneva, Switzerland; Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland; HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland) ; Armand, Stéphane (Department of Neurology, Geneva University Hospitals, Geneva, Switzerland; Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland) ; Chiuvé, Sabina Catalano (Department of Neurology, Geneva University Hospitals, Geneva, Switzerland) ; Burkhard, Pierre R. (Department of Neurology, Geneva University Hospitals, Geneva, Switzerland) ; Allali, Gilles (Department of Neurology, Geneva University Hospitals, Geneva, Switzerland; Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, USA)

Introduction High cognitive reserve is associated with milder cognitive and motor deficits in Parkinson's disease (PD). We investigated whether educational status (as a proxy for cognitive reserve) could modulate dual-task (DT) related gait changes after subthalamic nucleus deep brain stimulation (STN-DBS) in PD. Methods DT-related gait changes were assessed in 34 PD patients (age: 60.5 ± 8.7; % female: 44%), before and one year after STN-DBS. Based on walking speed change after DBS, patients were classified into responders (improvement) and non-responders (deterioration) using automated k-means clustering for four DT (i.e. forward and backward counting; semantic and phonemic fluency). Results Patients with high education level improved DT gait performance compared to lower educated patients (p = 0.03). Baseline cognitive performance, disease progression and stimulation efficiency were similar between groups (i.e. responders versus non-responders). Logistic regression showed an association between responders and high level of education for verbal fluency (semantic/phonemic fluency, beta = 3.9/3.4, p = 0.03). No significant changes for any gait parameter were found using all-group analyses. Conclusion Education level is associated with DT-related gait changes in PD one year post-DBS. Subgroup analyses should be considered for highly variable gait outcomes after STN-DBS. With regard to the predominance of motor-cognitive DT performance in everyday life, a high CR could be considered as a favourable inclusion criterion for future DBS candidates.


Keywords:
Article Type:
scientifique
Faculty:
Santé
Branch:
Physiothérapie
School:
HESAV
Institute:
Unité de recherche en santé, HESAV
Date:
2019-11
Pagination:
4 p.
Published in:
Parkinsonism & related disorders
Numeration (vol. no.):
November 2019, vol. 68, pp. 65-68
DOI:
ISSN:
1353-8020
Appears in Collection:

Note: The file is under embargo until: 2020-12-01


 Record created 2020-02-05, last modified 2020-02-14

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